CME: E-Cigarettes & Cough Reflex Sensitivity

CME: E-Cigarettes & Cough Reflex Sensitivity

Evidence suggests that electronic cigarette (e-cig) use has grown rapidly in recent years. “There seems to be a perception among the public—and perhaps even some physicians—that e-cigs are a benign substance because users are essentially inhaling water vapor,” says Peter V. Dicpinigaitis, MD. “However, few studies have assessed how e-cig use affects the respiratory tract or pulmonary function.” Previous studies have shown that otherwise healthy smokers of tobacco cigarettes experience decreased cough reflex sensitivity when compared with non-smokers. Dr. Dicpinigaitis is one of few researchers worldwide with the ability to measure the effects of an external influence on cough reflex sensitivity in the laboratory using capsaicin, which has been shown in previous research to induce cough in a safe, dose-dependent, and reproducible manner. With this background, he and his colleagues sought to determine the effects of a single exposure to e-cig vapor on cough reflex sensitivity.   A Closer Look For a study published in Chest, healthy adult lifetime nonsmokers visited a study site on 3 consecutive days. “Unlike previous research assessing cough reflex sensitivity in which chronic cigarette smokers were easy to recruit, there are few chronic e-cig users,” explains Dr. Dicpinigaitis. On Day 1 of the study, participants underwent cough reflex sensitivity measurements in order to establish a baseline. On Day 2, they underwent an e-cig vaping session using the disposable e-cig Blu (Fontem US, Inc). “Blu is one of the most commonly used disposable e-cigs in the United States, and use of a disposable e-cig is easiest for a research study,” says Dr. Dicpinigaitis. The vaping session consisted of 30 puffs on the e-cig 30 seconds...
E-Cigarettes & Cough Reflex Sensitivity

E-Cigarettes & Cough Reflex Sensitivity

Evidence suggests that electronic cigarette (e-cig) use has grown rapidly in recent years. “There seems to be a perception among the public—and perhaps even some physicians—that e-cigs are a benign substance because users are essentially inhaling water vapor,” says Peter V. Dicpinigaitis, MD. “However, few studies have assessed how e-cig use affects the respiratory tract or pulmonary function.” Previous studies have shown that otherwise healthy smokers of tobacco cigarettes experience decreased cough reflex sensitivity when compared with non-smokers. Dr. Dicpinigaitis is one of few researchers worldwide with the ability to measure the effects of an external influence on cough reflex sensitivity in the laboratory using capsaicin, which has been shown in previous research to induce cough in a safe, dose-dependent, and reproducible manner. With this background, he and his colleagues sought to determine the effects of a single exposure to e-cig vapor on cough reflex sensitivity.   A Closer Look For a study published in Chest, healthy adult lifetime nonsmokers visited a study site on 3 consecutive days. “Unlike previous research assessing cough reflex sensitivity in which chronic cigarette smokers were easy to recruit, there are few chronic e-cig users,” explains Dr. Dicpinigaitis. On Day 1 of the study, participants underwent cough reflex sensitivity measurements in order to establish a baseline. On Day 2, they underwent an e-cig vaping session using the disposable e-cig Blu (Fontem US, Inc). “Blu is one of the most commonly used disposable e-cigs in the United States, and use of a disposable e-cig is easiest for a research study,” says Dr. Dicpinigaitis. The vaping session consisted of 30 puffs on the e-cig 30 seconds...
Bladder Cancer & Tobacco Use

Bladder Cancer & Tobacco Use

According to research, about half of all bladder cancer cases diagnosed in the United States are the result of cigarette smoking. The disease is the second most common tobacco-related malignancy, a fact that is not well known among the general public. “Quitting smoking after being diagnosed with cancer can prolong survival, improve prognosis, and decrease the risk of developing second cancers,” says Jeffrey C. Bassett, MD, MPH. “Ensuring that patients are aware of the relationship between smoking and bladder cancer is paramount to their diagnosis being a ‘teachable moment’ to quit.” Few studies have looked at tobacco use knowledge and attribution of cause in patients with newly diagnosed bladder cancer. In a study published in Cancer, Dr. Bassett and colleagues sought to characterize patients’ knowledge of the link between tobacco use and bladder cancer risk using 2006-2009 data obtained from 790 respondents from the California Cancer Registry. The authors also looked at the impact of different sources of information on patients’ knowledge and beliefs regarding the cause of their bladder cancer. Degrees of Knowledge The study found that 68% of patients had a history of tobacco use, and 19% were active smokers when they were diagnosed with bladder cancer. Tobacco use was the most cited risk factor for bladder cancer, but active smokers were more knowledgeable on this association than former or non- smokers (90% vs 64% vs 61%, respectively). “Urologists also played a critical role in ensuring patients’ knowledge of the connection between smoking and bladder cancer,” Dr. Bassett says. The study showed that urologists were patients’ predominant source of information and were cited most often by active...
Performance Measures for CAD & Hypertension

Performance Measures for CAD & Hypertension

During the past decade, there has been increased awareness of the need to improve the quality of care delivered to patients with coronary artery disease (CAD) and hypertension. In keeping consistent with this focus, the American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) have developed guidelines and related performance measures that focus on these areas of care. In the July 12, 2011 issue of Circulation, the ACCF and AHA revised their original performance measures for adults with CAD and hypertension, which were developed in conjunction with the Physician Consortium for Performance Improvement (PCPI) and previously released in 2005. More Than a “Routine” Update for CAD & Hypertension With a general policy to revise performance measures no more than every 3 years, the AHA, ACCF, and PCPI had been working on revising the measurement sets for more than a year before they were published. “These new measurements represent a change in the science and methodology of how per­formance measures are typically developed,” says Joseph Drozda, Jr, MD, FACC, who co-chaired the PCPI panel. “The new mea­surements bring a focus on the outcomes of treatment rather than purely measures of process. We’re focusing on the things that make a difference and doing it in a way that will allow physicians to track their own per­formance in these key areas.” The 2011 ACCF/AHA performance measure sets consist of 10 total measures derived from several professional guidelines. It includes revisions to measures that were released in the 2005 document and five new measures (Table 1). “There are robust guidelines for CAD, supported by strong levels of evidence with respect...